North Dakota: thanks to the oil and gas industry, unpaid medical bills are up 30 percent

I recently blogged about a hospital in Pennsylvania that has its first budget loss in five years, due to workers in the oil and gas industry who do not have health insurance. I also blogged about a town in Montana that has hundreds of new schoolchildren each year, a crime rate that has almost doubled, and an overwhelmed volunteer fire department.

Now, according to EnergyWire, comes word from the North Dakota Hospital Association that unpaid bills in North Dakota's hospital have increased 30 percent over the past two years, due to oil field services employers that do not provide health insurance or only offer plans with very high deductibles. This is just another way that communities are struggling from the impacts of oil and gas development.

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Your link to EnergyWire requires a subscription, but the North Dakota Hospital Association has the underlying report at http://www.ndha.org/?id=21&ncid=2&nid=188 (Sorry, my HTML embed skills are non-existent!)

The NDHA story documents that the population in the area has increased tremendously. According to them, many towns have more than doubled in population. So it makes sense that many public services are strained. Why would it be surprising that unpaid bills to a hospital would increase by 30%? If the number of hospital visits more than doubles (again, from the NDHA report), their billable revenue should similarly double. If the percentage of patients who don't pay remains constant, I would expect a similar doubling in the value of unpaid bills. A 30 percent increase seems like a low and unremarkable number.

The article reflects that unpaid bills are accounting for 25-30% of revenue in some places. And the basic theme is correct, that the increases in unpaid bills _as a share of total revenue_ is unsustainable - services will have to be cut.

Dear Environmental Engineer: Thanks for posting the link. A North Dakota health expert says that most of these workers could afford to pay their medical bills - but they're not. This could lead to increases in prices or cuts in service for others. The oil and gas industry claims it brings substantial economic benefits to local communities, yet it never factors the costs into its calculations. The hospitals are seeing four to five times as many patients as they used to, and have enormous increases in treating major trauma in their ERs They say that it's not sustainable for them. The oil and gas industry needs to take responsibility for the burdens it is bringing to local communities, whether medical, economic, or environmental.

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